“What You Should Know About Your Antidepressants”

HOW ANTIDEPRESSANTS WORK: Most depression drugs work by changing the balance of brain chemicals called neurotransmitters, which affect your mood. They include serotonin, noradrenaline, and norepinephrine. Your primary care doctor can prescribe antidepressants. But if your symptoms are severe, they’ll refer you to a psychiatrist. That’s a doctor who specializes in mental health. Medication can help with depression symptoms, but it doesn’t always treat the causes of your depression.

WHAT DO ALL THOSE LETTERS MEAN? Different classes of antidepressants work on different brain chemicals. Tricyclics (TCAs) and serotonin norepinephrine reuptake inhibitors (SNRIs) raise serotonin and norepinephrine levels in your brain. Selective serotonin reuptake inhibitors (SSRIs) raise serotonin. Monoamine oxidase inhibitors (MAOIs) stop monoamine neurotransmitters from breaking down.

REALISTIC EXPECTATIONS: In general, antidepressants work really well, especially when used along with psychotherapy.  This combination may give you better results than using either treatment alone. Most people on antidepressants say they have eventual improvements in symptoms such as sadness, loss of interest, and hopelessness. But these drugs don’t work right away. It may take 1 to 3 weeks or more before you start to feel better and even longer before you feel the full benefit.

DO YOU NEED TO SWITCH? Talk to your doctor if your symptoms haven’t improved after 3 months. You may need a stronger dose or a different antidepressant. Many people don’t get relief from the first antidepressant they try. Also, depression meds may stop working in a small number of people who’ve been taking them for a while. If this happens to you, your doctor can help. Work together to find the treatment that’s right for you. It may take time.

BRAND NAME VS. GENERIC: The FDA says the generic drugs it approves are as effective as the brand-name versions. Both types have the same active ingredient. Ask your doctor if you can take the generic form of a drug. It may cost less than the brand-name version.

ANTIDEPRESSANT PITFALLS: You may be tempted to quit taking your medicine even though it’s working well. Or you might think about stopping because the dosing schedule is inconvenient, or because there are unpleasant side effects. Also, some people with depression don’t improve with antidepressants and must explore other treatment options.

TREATMENT-RESISTANT DEPRESSION: If newer antidepressants don’t work, your doctor may prescribe cyclic antidepressants. These were some of the first antidepressants made. They raise serotonin and norepinephrine levels in your brain.

ANTIDEPRESSANT SUCCESS: Keep taking your antidepressants for as long as your doctor says so (usually at least 6 months). Do this even if you feel better sooner, or your depression could return.

MANAGING SIDE EFFECTS: Don’t be shy in telling your doctor about any side effects. There are often ways to manage them. For example, taking your antidepressant with food can help nausea. If you’re having sexual problems, your doctor may change your medicine or add another one. If you feel fatigued, try taking your medicine 1 to 2 hours before bedtime. If the antidepressant causes insomnia, take it in the morning. Many side effects go away on their own after a few weeks.

DRUG INTERACTIONS: The antidepressants used most often today have fewer side effects and drug interactions than older versions. Still, any antidepressant can interact with other medications. Let your doctor know about any new prescription drug, over-the-counter medicine, or dietary supplement you plan to take. These could affect how your depression medication works.

FOLLOW-UP CARE: It’s important to keep going to all your doctor appointments while you’re on antidepressants. It’s common for depression to come back. That’s called a relapse. Your doctor may change the dose -- or prescribe a new medication -- if your symptoms return. Be sure to tell your doctor about any major changes in your life, such as losing a job, developing another medical condition, or becoming pregnant.

ANTIDEPRESSANTS AND ANXIETY: Your medication may make you feel jumpy or nervous. Exercise can help. Try a relaxing workout like yoga, or deep breathing exercises. Your doctor can switch you to a different antidepressant if that doesn’t help.

ANTIDEPRESSANT MYTHS: Some people worry antidepressants will turn them into a “robot.” The fact is, antidepressants can ease feelings of sadness, but they don’t get rid of your emotions. Another myth is that you’ll need to take the drugs for life. A typical course of antidepressants lasts 6 to 12 months in people who’ve had only a single episode of major depression. But you may need treatment longer if you’ve had multiple episodes of depression in your life. Also, if you’ve heard antidepressants are physically addictive, that’s not true. Still, you could have unpleasant symptoms if you stop taking them suddenly.

BENEFITS OF PSYCHOTHERAPY: Studies show “talk” therapy and antidepressants are often the most effective way to treat depression. Types of therapy include cognitive behavioral therapy, which focuses on changing negative thoughts and behaviors, and interpersonal therapy, which focuses on your relationships with others.

DEPRESSION AND EXERCISE: Exercise releases endorphins, chemicals linked to improved mood and lower rates of depression. Several studies suggest regular exercise is an effective treatment for mild to moderate depression. Group workouts or exercising with a partner may also be helpful.

COMING OFF YOUR ANTIDEPRESSANT: Your doctor will help you figure out the right time to stop your antidepressants. Quitting suddenly can cause unpleasant side effects or even a relapse. You could go into withdrawal for up to 2 weeks. You might be dizzy, nauseous, tired, or have headaches. Or you might get vertigo, which is when you feel like you or things around you are moving. Your depression symptoms may come back, too. Work with your doctor to slowly stop taking your medicine.

REVIEWED BY: Jennifer Casarella on December 02, 2019

REFERENCES:

Columbia University: "Generic Versus Brand-Name Drugs."
FDA: "Understanding Generic Drugs."
Harvard Medical School: "Exercise and Depression."
Kelly, K. Dialogues in Clinical NeuroSciences, December 2008; vol 10(4): pp 409–418.
National Alliance on Mental Health: "Depression: Medication and Treatment."
National Institutes of Mental Health: "Depression," "Rapid Antidepressant Works by Boosting Brain’s Connections."
Nyeon, J. Journal of the International Academy of Physical Therapy Research, 2010; vol 1: pp 5-9.
University of California, Berkeley, Tang Center: "Are You Considering Anti-Depressant Medication for Depression?"
University of Minnesota, Boynton Health Services: "Common Questions About Antidepressants."

Much Love, Dr.Shermaine, #InformativeRead #PleaseShare #HealthyBodySoulAndSpirit #IWantYou2LiveWell #FeelFree2SignUpAndFollow

The Goal is to Always Make You Aware of What Concerns Your Body, Soul and Spirit, So You Can Have Open, Honest and Frequent Discussions With Your Physicians and Counselors. You Can’t Treat or Cure What You Don’t Know is Sick.

"It's Not Selfish to Love Yourself, Take Care of Yourself and to Make Your Happiness a Priority. It's a Necessity." (Mandy Hale)

"Self-Care is Not Selfish. You Cannot Serve From an Empty Vessel." (Eleanor Brown)


The contents of the WebMD and Self-Care With Dr. Shermaine Sites, such as text, graphics, images, and other material contained on the WebMD and Self-Care With Dr. Shermaine Sites ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the WebMD and Self-Care With Dr. Shermaine Sites!

If you think you may have a medical emergency, call your doctor or 911 immediately. WebMD and Self-Care With Dr. Shermaine does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Sites. Reliance on any information provided by WebMD, WebMD employees, others appearing on the Site at the invitation of WebMD, and Self-Care With Dr. Shermaine or other visitors to the Sites is solely at your own risk.  

“Supplement Smarts: Best Ways to Take Different Vitamins”

MAKE FOOD YOUR PLAN A: With hundreds of supplements available, it’s hard to believe that not every nutrient in whole foods has been captured in a capsule. That’s why eating a variety of healthy foods is the best way to meet your health needs. But if you’re low on a certain vitamin or mineral, or just want to cover all bases with a daily MVM (multivitamin/mineral), these tips will help you get the most from it.

TIMING YOUR MULTI: You can take your MVM any time you’d like. Your body absorbs some of its vitamins better with food, so you may want to take it with a meal or a snack. You’ll also avoid the upset stomach that you can get when you take it on an empty stomach. Not a breakfast person? Have it with lunch or even dinner.

WHEN TO TAKE WATER-SOLUBLE VITAMINS: Water dissolves them, and your body doesn’t store them, so most must be taken every day. They include C and the B’s: thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxine (B6), biotin (B7), folic acid (B9), and cobalamin (B12). Take them with or without food, with one exception: You’ll absorb B12 better with a meal. If you also use vitamin C, put 2 hours between them. Vitamin C can keep your body from using B12.

WHEN TO TAKE FAT-SOLUBLE VITAMINS: Vitamins A, D, E, and K need to go with fat from a meal for your body to absorb and use them. But you don’t need a lot of fat -- or any saturated fat. The healthy plant-based kind you find in foods like avocado or nuts will do just fine.  

IF YOU TAKE IRON SUPPLEMENTS: You absorb iron best on an empty stomach. Take it with water or, better yet, a citrus juice: Iron and vitamin C have a tag-team effect. If it makes you queasy, save it for right after a meal. But don’t mix it with calcium or high-calcium foods -- these interfere with iron. You won’t take in either one fully. Men and postmenopausal women should skip supplements with this mineral unless a doctor says otherwise. The average MVM has more than you need.

IF YOU TAKE MINERAL SUPPLEMENTS: Large doses of minerals can compete with each other to be absorbed. Don’t use calcium, zinc, or magnesium supplements at the same time. Also, these three minerals are easier on your tummy when you take them with food, so if your doctor recommends them, have them at different meals or snacks. Don’t take any individual mineral at the same time as an MVM or an antioxidant vitamin formula, like one with beta-carotene and lycopene. 

IF YOU TAKE VITAMIN A: Watch the amount of what’s called preformed vitamin A. If you’re pregnant, doses over 10,000 IU a day can cause birth defects. High levels of both A and the usually safe beta-carotene (a substance that the body coverts to vitamin A) may raise your chances of having lung cancer if you’re a smoker, and maybe even if you’re a former smoker.

PRENATAL VITAMINS AND MORNING SICKNESS: Extra folic acid and iron are very important for a healthy baby. You might even take folic acid before you get pregnant. But prenatal vitamins can make nausea worse, mostly because of the iron. If this happens to you, pair your prenatal vitamins with a light snack before you go to bed. Talk to your doctor about the best prenatal formula for you.

SUPPLEMENTS AND YOUR PRESCRIPTIONS: Even essential nutrients can interfere with many common medications. If you take a traditional blood thinner like warfarin, just the small amount of vitamin K in an MVM can cut its strength. Taking more than 1,000 mg of vitamin E per day can raise your risk for bleeding. And if you take thyroid medication, taking calcium, magnesium, or iron within 4 hours can cut its strength. Ask your doctor about how best to time it.

THE ALPHABET OF AMOUNTS: RDA (recommended daily allowance) is the daily amount of a nutrient you should get, based on sex and age. DV (daily value) is the percentage of a nutrient that a supplement or food serving adds to the average daily diet for all ages. UL (upper limit) is the most of a nutrient you should get in a day. Side effects from big doses range from tiredness or diarrhea to kidney stones or organ damage.

KNOW WHAT’S INSIDE: There’s no one standard MVM formula. Some have more nutrients than recommended. Others may come up short on some RDAs. For instance, the amount of calcium you need to meet the RDA is too much to fit into a tablet that you could easily swallow. Scan the full ingredients list so you know exactly what’s in the supplement you’re considering. This will also help you know if you need to time when you take it. 

PERSONALIZE YOUR FORMULA: Another way to get more of the nutrients you need is to shop for formulas geared to your age and sex. For example, many vitamins for seniors have more calcium and vitamins D and B12 than younger people need. As you get older, your body doesn’t do as good a job of absorbing B12. Women, in particular often need extra calcium and vitamin D after menopause to protect bones. Men’s formulas leave out the iron.

ARE GUMMIES ANY GOOD? Opinions about gummy vitamins are mixed. One study found that people who take vitamin D in gummy form get more from it than from a tablet. On the other hand, gummies can have a lot of sugar and calories. And because they taste like candy, it’s easy to go overboard and eat too many. They may even cause cavities. Also, not all brands contain all essential vitamins and minerals. Some may not even contain the amounts listed on the label.

LOOK FOR QUALITY CHECKS: Since the FDA doesn’t regulate supplements, look for brands that have been “verified” by one of the three companies that test supplements in the U.S.: Pharmacopeia, Consumer Lab, or NSF International. These testing organizations verify that what’s on the label is in the bottle in the right amounts.

KEEP A SUPPLEMENT DIARY: If you keep a log, it can help you time out different supplements and keep track of how much you take every day. The National Institute of Health’s Office of Dietary Supplements has a form called "My Dietary Supplement and Medicine Record" that you can print out and fill in. Bring it with you, along with your medication list, when you go to doctor visits.

REVIEWED BY: Melinda Ratini, DO, MS on February 07, 2020

SOURCES:

Mayo Clinic: “Nutrition and Healthy Eating,” “Vitamin B12,” “Iron Supplement,” “Prenatal vitamins: Why they matter, how to choose.”
National Institutes of Health Office of Dietary Supplements: “Multivitamin/mineral Supplements,” “Vitamin A,” “Daily Values,” “Frequently Asked Questions,” “Vitamin and Mineral Upper Limits -- What You Need to Know,” “Dietary Supplements: What You Need to Know."
UT Southwestern Medical Center: “5 signs you’ve chosen the right multivitamin.”
Cleveland Clinic: “Get Nauseous After Taking Vitamins? 6 Tips to Make Them Easier to Stomach,” “Vitamin B12 Oral.”
Harvard Health: “B Vitamins,” “What patients -- and doctors -- need to know about vitamins and supplements.”
ConsumerLab.com: “Supplements That Should Be Taken With Food,” “Best Time to Take Multivitamins,” “How to Take Vitamins and Minerals for the Proper Absorption,” “Gummy Vitamin Concerns.”
Linus Pauling Institute: “Vitamin E.”
New England Journal of Medicine: “Drug Effects on the Thyroid.”
Colorado State University Extension: “Dietary Supplements: Vitamins and Minerals.”
Nutrients: “Bioequivalence Studies of Vitamin D Gummies and Tablets in Healthy Adults: Results of a Cross-Over Study.”
Center for Science in the Public Interest: “Don’t Rely on a Gummy Multivitamin If You Can Swallow a Tablet.”

Much Love, Dr.Shermaine, #InformativeRead #PleaseShare #HealthyBodySoulAndSpirit #IWantYou2LiveWell #FeelFree2SignUpAndFollow

The Goal is to Always Make You Aware of What Concerns Your Body, Soul and Spirit, So You Can Have Open, Honest and Frequent Discussions With Your Physicians and Counselors. You Can’t Treat or Cure What You Don’t Know is Sick.
 
"It's Not Selfish to Love Yourself, Take Care of Yourself and to Make Your Happiness a Priority. It's a Necessity." (Mandy Hale)

"Self-Care is Not Selfish. You Cannot Serve From an Empty Vessel." (Eleanor Brown)

The contents of the WebMD and Self-Care With Dr. Shermaine Sites, such as text, graphics, images, and other material contained on the WebMD and Self-Care With Dr. Shermaine Sites ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the WebMD and Self-Care With Dr. Shermaine Sites!

If you think you may have a medical emergency, call your doctor or 911 immediately. WebMD and Self-Care With Dr. Shermaine does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Sites. Reliance on any information provided by WebMD, WebMD employees, others appearing on the Site at the invitation of WebMD, and Self-Care With Dr. Shermaine or other visitors to the Sites is solely at your own risk.